the body.com

[powerpuff]

this is interesting....posted on the body.com
a person diagnosed in 2007 could lead normal lifespan?
i find that hard to swallow....considering people still die of this disease duh?
however if new treatments and breakthroughs finally come out that could happen ? my money is on gene therapy and mutantgenesis whatever it's called..
what do you think?/??

[Jake72]

I was diagnosed eight years ago and was told that it was likely that someone diagnosed then could have a normal lifespan. 

Just because there are people who unfortunately die from a condition does not mean that everyone will die from it.  People still die from asthma and allergies, for instance, but this doesn't mean that everyone with asthma and/or allergies will die from them.  The same can be said for diabetes and many other conditions.

When people die from AIDS, they die for a large variety of reasons.  They may not be taking their medications compliantly or at all; they may have been diagnosed at such a dire point that a comeback would have been highly unlikely, etc. 

What we do know, of course, is that the death rate from AIDS has plummeted since the mid-1990s and that, happily, many people with HIV are planning for long, healthy futures (school, careers, buying homes, having families, saving for retirement).   

[fondeveau]

My doctor told me to plan long, long, long-term.  And I was so hoping to retire early....

[Miss Philicia]

http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2002supp_vol8no1/figure10.htm

This shows a huge decline in AIDS death rates when protease inhibitors came out.  It stops at the year 2000 but the following shows the rates stable since then around 17-18,000:

http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2005report/pdf/2005SurveillanceReport.pdf

I'd be interested in seeing a reputable analysis of these deaths and why the number has not continued to decline. 

And here is a 1999 article attempting to describe why it's not gone yet lower but of course that's very out of date by now.

[bimazek]

philly thanks for that great great diagram really give great hope and puts all the risks in perspective

what i notice for the chart is

accidents are 4 times or 400% more likely to kill a person

cancer is twice as likely to kill a person than

looks like smoking and over eating is doing alot of damage too

[Miss Philicia]

Well, my greater point is that post-protease inhibitors we've had pretty much no improvement in lowering the death rate.  I'm not particularly satisfied that we seemed to have bottomed out for 7 years at 17-18,000 deaths per year.  Personally I know three people who have passed away in the past two years, though not close enough that I know exactly why they died.  Treatment failure?  Resistance?  Bad adherence?  Who knows.

We'll know in the next three years if these new drugs coming out, all of which seemed to be aimed at those of us with resistance issues, causes the death rate to decline significantly.

People new to HIV should still be cognizant that there are still folks croaking, though of course significant gains have been made in the past decade.  Very significant.

[Central79]

I'm not sure that you can say survival hasn't gotten better over since the PIs came out. I read a really interesting Danish study that basically said that a 25 year old diagnosed in 2006 could expect to live about 40 years on current therapy, which is about 11 years less than his HIV -ve counterpart.

They also compared early, "mid" and late HAART and found that survival improved over that time - I don't think that's just down to the introduction of new drugs, even if they were in existing classes, but also better understanding of how best to use them.

The reference, for those of you who are interested is: Survival of Persons With And Without HIV Infection In Denmark 1995-2005, Lohse et al., Annals of Internal Medicine 2007 Vol 146; p. 87-95. I also have it as a pdf for anybody who wants to read it.

So if this study is knocking 11 years off our lives with HIV now, with current therapy, then I think over the lifetime of that person significant advances are going to be made in the treatment of HIV - and perhaps eradication. I personally don't believe I will die either with, or from, HIV.

The other thing I wanted to say is that 25% of people who die from HIV die because they are diagnosed too late, and the drugs don't have time to work. And a lot more start therapy (and survive) at much too low a CD4 count. Just changing stuff like this: picking it up early, treating when appropriate, will make a big difference to the figures.

M.

[bimazek]

philly thanks for that great diagram that would have been great when i was so worried about cancer dangers a month ago and was posting about that... but after i studied the diagram for a long time then i was thinking about it

and then i was driving to gym and thinking about he diagram...

this diagram is per 100,000 average people, so that is why the hiv death rate is so so low

if you say that one in 200 americans are positive

then you have to multiply the low number on this chart by 200

and leave the other lines low!!!!

so deaths from hiv per 100,000 people with hiv would be 2000 per year or 10 x 200

and that would be off the chart and dwarf all the other diseases

but if the graph were drawn for hiv poz only  then

we would see all those other diseases doubling too

anyway

i got upset and despressed when i thought about it so

i didnt post it

but i just saw it again

but i do believe that 20 or 30 years is possible today with what meds are on market today

and the new meds and gene therapy will push that out

the most important thing... is dont drink, use drugs, dont use poppers, or smoke or any other co factors that would hurt the body

[Central79]

2000 deaths per 100,000 is still only 2% of HIV+ people dying per year.

This doesn't actually sound that high to me - the death rate for the whole population in the UK is about 1% per year, so the rate you are quoting is only twice that of the general population.

Not bad for a disease that was a death sentence before 1996.

[Miss Philicia]

I'm not sure that you can say survival hasn't gotten better over since the PIs came out.

Did someone make that statement here?

[Miss Philicia]

dont use poppers

Would you mind halting this incessant crusade of yours that is NOT based on any science?  It's getting old... as old as Roy Cohn.

[Miss Philicia]

2000 deaths per 100,000 is still only 2% of HIV+ people dying per year.

This doesn't actually sound that high to me - the death rate for the whole population in the UK is about 1% per year, so the rate you are quoting is only twice that of the general population.

Not bad for a disease that was a death sentence before 1996.

Sure, if you want to be disingenuous and compare natural death causes (i.e. old age) with a retrovirus that's still not as completely treatable as all the doctors would like you to believe.

[Central79]

What's disingenuous about it? I'm basically saying that I'm surprised by bizmazek's being "upset and depressed" about this, when something which was really untreatable until the mid-90s now only has twice the death rate of the general population - like many other conditions. I'm saying "look how far we've come". People in the population don't just die from old age - they also die from cancer, heart disease, etc, that are no more or less "natural" than dying from HIV.

I'm saying the same thing when I point out the improvement in death rates, not just pre- and post-HAART, which nobody disputes, but also throught the HAART period, where the death rate has fallen.

I'm NOT saying that things are great. Or that some people are not failed by therapy. I AM saying look how far we've come and that I have hope for continuing improvement in the future.

Did someone make that statement here?

Philly - unless I'm reading you wrong  , you stated there hasn't been a lowering of the death rate since the introduction of PIs (post-PI). I was quoting a study that said the opposite.

Well, my greater point is that post-protease inhibitors we've had pretty much no improvement in lowering the death rate. 

[milker]

bimazek,

you need mental health help. You are obviously scared to death (pun intended) about HIV, and reading medical papers looking for hope is not how you can possibly live for the rest of your life, or you're going to completely destroy yourself.

Please seek a professional.

Milker.

[Miss Philicia]

I AM saying look how far we've come and that I have hope for continuing improvement in the future.

Philly - unless I'm reading you wrong  , you stated there hasn't been a lowering of the death rate since the introduction of PIs (post-PI). I was quoting a study that said the opposite.

Well, in some ways we're saying the same thing.  Yes, the world of HIV is immensely better since '96's AIDS death rates dropped precipitously.  However, the CDC data indicates that once there was the initial drop over a 2 year or so period, the new rates have stayed stable for almost a decade.  So actually there have been no improvements in the AIDS death rates for a decade.  Are you actually arguing with the CDC's numbers or am I misunderstanding your post?

I'd love to see a full analysis of the AIDS deaths and why the numbers seem to stay stable.  I agree that much of it, as you said, is because individuals don't become diagnosed until they have 4 t-cells, but I want to know the exact number.

Look, I personally know of 4 individuals (acquaintances, not close friends) who have croaked from HIV in the last 2 years.  Sorry, it's still going on to a large degree... maybe you just don't personally know enough infected individuals since you're so newly diagnosed (and now, that's not a "newbie" slam, just a fact).

As far as bimazek getting upset with this discussion well... what can I say?  He needs to realize that HIV is serious and he needs to start dealing with it more mentally instead of fixating on poppers and overdosing on medical literature.

[Central79]

Hey,

I'm not really in a position to dispute the CDC data, as I haven't seen it. I have no idea really what the picture is in the United States. But this study done in Denmark showed a clear improvement in survival with "early" compared to "mid" compared to "late" HAART. By following every HIV+ person in Denmark, they were able to power the study significantly to show a decline in mortality.

From the sounds of it, it doesn't seem like the CDC are breaking down their numbers enough. For example, the medicine could have gotten better since 1996, and people diagnosed in good time be doing better and better. But if a larger proportion of people are being diagnosed too late that would mask any improvement in survival from better drugs.

I'm definately not saying that people no longer die from HIV. I am making a very specific point, which is what this paper tried to seperate out, that the medication is getting better and survival for those people diagnosed in time is improving markedly year on year.

I know that HIV+ people still run out of options, and that drugs fail a significant minority, and I know that a significant proportion of people get diagnosed very late and die as a result. I am definately not saying that we haven't got a long way to go.

I definately don't feel "slammed" as a newbie. It's true I didn't have any HIV+ friends before being diagnosed, and I still don't - I just have a few acquaintances. I know how frustrating it must seem to people who have watched friends die and who have been very ill from HIV have somebody like me say: "the drugs are great now! No worries..." I hope you understand I am definately not saying that. I'm just marking progress, and being optimistic for the future.

I really don't know how biz is dealing with HIV. For all we know, he's a fully functioning human being who just comes on here and has a bit of a mania for poppers and death. Let's not judge him too harshly.

M.

PS - Philly, I'll PM you this study if you like?

[Jake72]

From the sounds of it, it doesn't seem like the CDC are breaking down their numbers enough. For example, the medicine could have gotten better since 1996, and people diagnosed in good time be doing better and better. But if a larger proportion of people are being diagnosed too late that would mask any improvement in survival from better drugs.

And let's not forget that there is a segment of the HIV+ population that simply refuses treatment with HAART.  Maybe these people have been put off by stories of side effects, are in denial, or don't want to be slaves to pill bottles.  Even if the medications were 100% effective, they wouldn't work on people refusing to take them.   

[Miss Philicia]

Yes, PM me the study Matt.  Thanks.  Or if it is a .pdf file PM me and I'll give you my email address.